Processing grief: Prolonged grief disorder and DSM-5-TR

Prolonged grief disorder is now a diagnosis in the new DSM-5-TR. So how cool are you to get to be a disorder?!! Well maybe not that cool – as we all know this stuff is hard to experience. But prolonged grief disorder (aka “complicated grief”) has been proposed as a unique diagnosis for a while now.

Prolonged grief disorder made it into the initial DSM-5 as a preliminary research diagnosis. However, studies continue to demonstrate that it is a distinct psychological experience from things like major depression and posttraumatic stress.

Prolonged grief and grief processing research findings

Efforts to understand prolonged grief have led multiple researchers to find that the long-assumed need to “process” one’s grief by spending extensive time trying to understand one’s loss can actually do more emotional harm than good. And it may increase the chances of experiencing prolonged grief!

Dr. George Bonanno at Columbia University wrote a really good book on grief and prolonged grief. This book uses plain language to integrate research in this area with personal stories. It’s great for both clinicians and consumers!

What it means for therapy and consumers

Most mental health professionals agree with what research finds: there is no “right way” to grieve. But maintaining contact with routines and behaviors that humans find stabilizing and meaningful appears to be most helpful after loss. Examples of these routines and behaviors are going to work, engaging with friends and family, and doing activities we enjoy. This continued engagement holds true even if it feels strange for the individual to do it. This is because research links the degree we grieve to the number and types of roles/activities we attribute to our identity.

So staying engaged in those “you” things can help maintain that identity. This will also produce a healthy degree of eventual “letting go”. All the while, we humans never actually forget how much what we lost meant to us.